| NPI | 1699340752 |
|---|---|
| Former Name | TIFFANY LENELL BENJAMIN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: SC 24863) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: GA GAA-NP000174) |
| 363LF0000X Nurse Practitioner Family (Licence: SC APN.24863) | |
| 363LP2300X Nurse Practitioner Primary Care (Licence: SC APN.24863) | |
| Enumeration Date | 2021-05-21 |
| Last Update Date | 2022-11-02 |